Psychotropic medication and the heart: Part 2

In the first module, Psychotropic medication and the heart: Part 1, we summarised normal ECG, the effect of psychotropic medication on heart rate, blood pressure and the use of psychotropic medication in coronary heart disease.


A number of  psychotropic medications are known to have serious cardiac side-effects. These include prolonged QT interval, which is associated with an increased risk of arrhythmia and sudden death (Taylor, 2003). Drug-induced prolonged QT interval change is potentially preventable. However, clinicians should make patients aware of such risks in order to gain informed consent for treatment.


While prescribing psychotropic medications, clinicians should consider predisposing risk factors and drug interactions (Gupta et al, 2007). More recently, attention has focused on cardiovascular complications reported in association with clozapine. These include myocarditis and cardiomyopathy, which in some cases has resulted in sudden cardiac death (Merrill, 2005).


In this module, we will consider the normal conductive system of the heart, and the effect of psychotropic medication on its functioning. Furthermore, we will discuss the effects of psychotropic medication on cardiac rhythm and on cardiac muscle and contractility.


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Please note: This module was published in 2011. A revision is being worked on, but in the meantime please be aware when completing the module that some of the guidance may have changed.


If you like this module, you may also be interested in:


Psychotropic medication and the heart: Part 1 by Dr Sridevi Sira Mahalingappa, Professor Femi Oyebode and Dr Patrick O'Brien


Don't shrink... from ECGs: Part 1 and Part 2 by Dr Luke Solomons, Dr Jim Crabb and Dr Adrian Treloar


Managing depression in physical illness by Dr Janet Butler and Dr Annabel Price


Pharmacological treatment of resistant depression – an overview

by Professor Philip J. Cowen



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